Breastfeeding Rates Rise, but Still Disappoint

Action Points

Breastfeeding rates have increased significantly in recent years across all racial and ethnic groups, although wide disparities persist.

Note that by 2008, the overall rate of breastfeeding initiation had increased to 74.6%, the 6-month rate to 44.4% , and the 12-month rate to 23.4%.

Breastfeeding rates have increased significantly in recent years across all racial and ethnic groups, although wide disparities persist, a study from the CDC showed.

From 2000 to 2008, the proportion of new mothers who started breastfeeding increased from 70.3% to 74.6%. Initiation rates increased significantly among blacks and whites. More Hispanics were breastfeeding at the end of the study period, but the difference from 2000 did not reach statistical significance, according to Jessica A. Allen, MPH, and co-authors.

The historical disparity among blacks continued, but the gap narrowed significantly, they reported in the Feb. 8 issue of MMWR: Morbidity and Mortality Weekly Report. But the duration of breastfeeding continued to fall well short of recommendations.

"Despite increases in the prevalence of infants ever breastfeed and breastfeeding for 6 and 12 months, only a small percentage of infants were breastfed for the recommended minimum breastfeeding duration of 12 months, indicating that mothers might need support to continue breastfeeding," the authors said in conclusion.

In January, the American Academy of Pediatrics (AAP) reaffirmed its support of breastfeeding and human milk as the "normative standards for infant feeding and nutrition." The academy recommends exclusive breastfeeding for 6 months and then continued to 12 months or longer as solid foods are introduced into a baby's diet.

Using the AAP recommendations as a guideline, the CDC investigators reviewed data from the National Immunization Survey (NIS) for infants born during 2000 to 2008. The NIS telephone interviews were conducted 2 to 3 years after the infants were born (2002 to 2011).

For infants born in 2000, the overall proportion of babies that started breast feeding was 70.3%. Additionally, 34.5% of the infants had been breastfed for 6 months and 16.0% for 12 months.

By 2008 the overall rate of breastfeeding initiation had increased to 74.6% (P<0.05), the 6-month rate to 44.4% (P<0.01), and the 12-month rate to 23.4% (P<0.01).

The study also found:

By race/ethnicity, initiation rates increased from 71.8% to 75.2% among whites (P<0.01), from 47.4% to 58.9% among blacks (P<0.01), and from 77.6% to 80.0% among Hispanics (NS).

The proportion of infants who were breastfed for 6 months increased from 38.2% to 46.6% among whites, 16.9% to 30.1% among blacks, and from 34.6% to 45.2% among Hispanics (P<0.01 for all comparisons).

The rate of breastfeeding at 12 months increased from 17.1% to 24.3% among whites, 6.3% to 12.5% among blacks, and 18.2% to 26.3% among Hispanics (P<0.01 for all comparisons).

"Although 74.6% of infants overall began breastfeeding in 2008, only 23.4% had the recommended duration of 12 months of breastfeeding," the authors said in their discussion of the findings. "In addition, although differences might be decreasing between black infants and white and Hispanic infants, consistently lower prevalence of breastfeeding among black infants warrants increased attention and action."

The authors acknowledged several limitations of the study: response rates to the NIS ranged from 61.6% to 74.2% across the study period, users of cellular telephones were excluded until 2011, and the 2000 cohort was smaller than others because only 2 years of survey data were included and only a sample of respondents were asked breastfeeding questions in 2002.

The study was supported by the CDC.

The authors had no relevant disclosures.

Reviewed by Robert Jasmer, MD Associate Clinical Professor of Medicine, University of California, San Francisco and Dorothy Caputo, MA, BSN, RN, Nurse Planner

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